| Wellington Provider Group PC | |
|
145 W Ostend St Ste 600 Baltimore MD 21230-3774 | |
| (859) 518-8817 | |
| (859) 201-1084 |
| Full Name | Wellington Provider Group PC |
|---|---|
| Speciality | Family Medicine |
| Location | 145 W Ostend St Ste 600, Baltimore, Maryland |
| Authorized Official Name and Position | Mariela Bravo (CREDENTIALING TEAM LEAD) |
| Authorized Official Contact | 8595188817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellington Provider Group PC 535 Wellington Way Ste 330 Lexington KY 40503-1331 Ph: (859) 518-8817 | Wellington Provider Group PC 145 W Ostend St Ste 600 Baltimore MD 21230-3774 Ph: (859) 518-8817 |
| NPI Number | 1841902004 |
|---|---|
| Provider Enumeration Date | 12/20/2022 |
| Last Update Date | 12/20/2022 |
| Certification Date | 12/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841902004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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